His little heart was pumping at 240 beats a minute, his temperature had topped 40.3C, he couldn’t breathe on his own and, worst of all, no one knew why.
Little more than a day earlier Lennox Knight was a happy, healthy 1-year-old who loved hide and seek, was besotted with his big sister and was a devoted fan of his dad’s alt rock band.
But he’d also fallen victim to a health mishap that wouldn’t be resolved until doctors put a camera into his lungs at Starship children’s hospital - where the critically ill Waipu tot had been flown by rescue helicopter - and sucked out a straggly bit of chicken.
There were moments the unimaginable - life without Lennox - went through his mind, dad Dave Knight said.
“The day before, your little boy is laughing with you. And then he’s just a motionless body, you don’t know if he is ever gonna wake up.”
The first sign something was wrong came on December 2 when Lennox developed a rasp, mystifying Knight and partner Aneta Tarabova, as daughter Kiera, 4, hadn’t brought any illnesses home from daycare.
But Lennox, who’d turned 1 a week earlier, was still eating, playing and sleeping normally.
The next night he began coughing and having trouble breathing, and when Whāngārei White Cross opened at 7am he was the first patient seen, with an ambulance called because oxygen wasn’t helping his suspected respiratory infection.
At Whāngārei Hospital, Lennox’s condition deteriorated further and by 9.30am he was in the intensive care unit (ICU), Knight said.
“They thought the machine was broken because his sats [oxygen saturations] were so low … it escalated so quickly, probably over an hour and a half, two hours.”
Lennox was put on a ventilator and a paediatric intensive care doctor and nurse were dispatched by rescue helicopter from Starship to make the return journey transferring the tot to Auckland.
But with stormy weather in both regions there were fears the helicopter mightn’t be able to make the journey and - even if it did - could then struggle to land on Whāngārei Hospital’s roof, Knight said.
“They said, ‘If we can’t we might be able to go to the airport and get a plane’, but in my mind he’s just going downhill so really, we need the helicopter. We need to get him there as quickly as possible.”
Even when they got airborne in the Auckland Westpac Rescue Helicopter, landing at Starship wasn’t guaranteed, said Tarabova, who flew with Lennox to Auckland.
“They were discussing with me whether to land … at the Domain, they were saying, ‘It’s going to be all soggy’ and I was like ‘I don’t care. It’s close to the hospital. I don’t care about the mud [on the] helicopter or my shoes.”
Fortunately they were able to land at Starship about 9pm, where an x-ray showed Lennox had suffered a collapsed lung.
Although they hadn’t seen Lennox choke, doctors decided to put a camera into his lungs about 1am.
“Does this look like chicken?” Knight recounts a doctor saying as the culprit - from the family’s apricot chicken meal three days earlier - was discovered.
Aspiration - where something is sucked into the lungs - was diagnosed.
“In normal circumstances we inhale something and it causes choking, but through the choking you can address that issue straightaway. But in Lennox’s case he managed to inhale food and liquid without any [sign of] choking.”
And although Lennox remained sedated and intubated for several days after the errant morsel caused a severe infection, it was clear the worst had passed.
Within a day his collapsed lung had reinflated, and it took just 10 minutes for his temperature and heartbeat to fall, Knight said.
“His heartbeat went from 240 to 163, and his temperature went down to 38C … for me, that was the relief. I thought, ‘As long as his little ticker’s not gonna stop, it’ll be okay’.”
The couple wanted parents to know aspiration could occur without obvious signs of choking, Tarabova said.
“We’re there with him 100 per cent of the time, feeding and assisting him. It’s not unusual for a little cough, because he was still learning [how to eat].”
Aspiration was common, especially with toddlers as “they’re constantly putting things in their mouth”, Starship ICU doctor Anusha Ganeshalingham said.
And it could happen without a fuss.
“Just because you haven’t witnessed a coughing episode or a choking episode, it doesn’t mean they haven’t aspirated some food into their lungs.”
Her own daughter made no noise when she suffered a choking incident, Ganeshalingham said
“She was sitting in her baby seat and I saw her shoulders shrug up and down … when I came around [from behind] to look at her she was sort of choking but not making any noise, and she had a blue marble in her mouth.”
Coughing, difficulty breathing, wheezing - a “funny noise” made when breathing from your lungs - were signs to look for, but also showed those choking were able to “move some air”.
“When there’s a complete obstruction, you’re not moving any air. It’s silent. Those are probably the ones you worry about the most.”
The abdominal thrusts used in the Heimlich manoeuvre were no longer recommended.
If someone’s coughing and trying to clear their airway “just let them do it”, Ganeshalingham said.
“Don’t try and intervene because they’re getting themselves in the best position to rearrange themselves, so they can clear their secretions.
“But I’d call 111 for anything more that’s prolonged, or they’re changing colour, or silent choking.”
The New Zealand Resuscitation Council advises people to deliver five back blows to people who are choking without an effective cough.
If the back blows don’t dislodge whatever is blocking the airways, then five chest thrusts - similar to CPR - is advised as well as calling 111.
Raising awareness wasn’t the only reason Lennox’s mum and dad were talking about his emergency - they also wanted to thank everyone who helped save their little boy’s life, from medical staff to the rescue helicopter crew who battled foul weather to get him where he needed to be, Knight said.
“This is a beautiful story with a beautiful, happy ending, because of all the possibilities that could’ve happened - the timing, the fact the helicopter could land at both ends, the staff at [Starship] PICU, the staff at Whāngārei, they were all amazing.
“It’s a happy ending, because we’ve still got our son, and we can tell the story.”
Cherie Howie is an Auckland-based reporter who joined the Herald in 2011. She has been a journalist for more than 20 years and specialises in general news and features.
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